Fabrication and Characterization of Nanocomposite Hydrogel Based on Alginate/Nano-Hydroxyapatite Loaded with Linum usitatissimum Extract as a Bone Tissue Engineering Scaffold.

In the current paper, we fabricated, characterized, and applied nanocomposite hydrogel based on alginate (Alg) and nano-hydroxyapatite (nHA) loaded with phenolic purified extracts from the aerial part of Linum usitatissimum (LOH) as the bone tissue engineering scaffold. nHA was synthesized based on the wet chemical technique/precipitation reaction and incorporated into Alg hydrogel as the filler via physical cross-linking. The characterizations (SEM, DLS, and Zeta potential) revealed that the synthesized nHA possess a plate-like shape with nanometric dimensions. The fabricated nanocomposite has a porous architecture with interconnected pores. The average pore size was in the range of 100-200 µm and the porosity range of 80-90%. The LOH release measurement showed that about 90% of the loaded drug was released within 12 h followed by a sustained release over 48 h. The in vitro assessments showed that the nanocomposite possesses significant antioxidant activity promoting bone regeneration. The hemolysis induction measurement showed that the nanocomposites were hemocompatible with negligible hemolysis induction. The cell viability/proliferation confirmed the biocompatibility of the nanocomposites, which induced proliferative effects in a dose-dependent manner. This study revealed the fabricated nanocomposites are bioactive and osteoactive applicable for bone tissue engineering applications.

Femoral Stem Dislocation Caused by Trunnionosis Along with Adverse Local Tissue Reaction: A Case Report and a New Technique of Head to Cone Cementing.

In total hip replacement (THR), fretting and corrosion at the modular head-neck junction (trunnionosis) may cause adverse local tissue reaction (ALTR). In this report, we presented a 34 years woman with a history of THR eight years ago, presenting with acute pain and limping. The radiographic assessment revealed stem-head dislocation for which a revision hip surgery was planned. Surprisingly, we observed pseudotumor and tissue necrosis resulting from the body's reaction to cobalt-chromium alloy. The revision surgery entailed pseudotumor debridement and replacing the femoral head with a new metal head (size 36, long). Due to the separation of the femoral head on a stem, we fixed it on a stem using bone cement. The stem (Omnifit®, Stryker®) was well-fixed and retained to avoid fractures and infection risk. This technique revealed an acceptable outcome without recurrence of ALTR after a one-year follow-up. Our findings suggest that stem dislocation secondary to trunnionosis might be a long-term complication after THR with subsequent ALTR.

Extensile approach versus minimally invasive technique in management of calcaneus fractures.

BACKGROUND: Calcaneus fracture is one of the important fractures in orthopedic surgery. Here we aimed to investigate and compare the extensile approach and minimally invasive technique in patients with calcaneus fractures. METHODS: This is a randomized clinical trial that was performed in 2019 in Kashani and Alzahra hospitals in Isfahan, Iran. The study population consisted of 30 patients with intraarticular calcaneus fractures. Thirty patients were divided into two groups. In the first group, surgery was performed using the minimally invasive technique and in the second group, the extensile approach was performed. Patients were followed for 12 months. Data regarding the duration of surgery, Boehler and Gisan angles, quality of joint reduction, subtalar joint movement, the incidence of soft-tissue complications and pain of the patients were measured and compare between two groups. RESULTS: A total number of 30 patients entered the study and were divided into two groups each containing 15 patients. The duration of operation in the extensile approach group was significantly higher than the minimally invasive group (P = 0.03). The severity of pain and mean Boehler angle were significantly higher in the minimally invasive group than in the extensile approach group (P = 0.001 and P = 0.002 respectively). The quality of reduction was also significantly better in the extensile approach group than minimally invasive (P = 0.01) but the extensile approach group had more soft tissue complications than the minimally invasive group (P = 0.006). CONCLUSION: Extensile approach was associated with lower pain, lower Boehler angle and better quality of reduction compared to minimally invasive technique but also higher operation duration and surgical site complications. We suggest that the extensile approach should be used in patients with calcaneus fractures with attention to possible complications.

Hydatid cyst of urinary tract: 11 cases at a single center.

INTRODUCTION: We retrospectively reviewed clinical records of 11 patients with hydatid cyst of the urinary tract admitted to our institution from 1998 to 2005. MATERIALS AND METHODS: Hospital and follow-up records of 11 patients with hydatid cyst of the urinary tract were reviewed and data on the patients' symptoms and signs at presentation, radiological findings, diagnostic tests, pathologic findings, and surgical outcomes were reviewed. RESULTS: The chief complaint was flank pain in 7 patients (63.6%). Hydaturia was not seen in any of our patients. Ten patients had renal involvement and 1 had a retrovesical hydatid cyst. Eosinophilia was detected in 2 of 11 patients who were tested. A positive indirect hemagglutination test was seen in 4 of 7 patients and a positive Casoni test in 1 of 2. Intravenous urography revealed caliceal distortion in 6 patients (54.5%), caliectasis in 3 (27.3%), and nonfunctioning kidney in 2 (18.2%). Ultrasonography showed a complex cyst in all of the patients. Computed tomography demonstrated multivesicular cystic structure in 4 patients (36.4%), complex cyst in 4 (36.4%), and a simple cyst in 3 (27.3%). Definite diagnosis was made only after surgical operation. We performed nephrectomy in 2 patients (18.2%), partial nephrectomy in 2 (18.2%), cystectomy plus marsupialization in 5 (45.4%), and retrovesical surgery in 1 (9.1%). One patient refused surgical treatment. There was no perioperative major complication. CONCLUSION: Renal hydatidosis is a rare entity and the main challenge is preoperative diagnosis. Radiological and serologic studies, although indicative, cannot confirm the diagnosis, and only pathologic examination after surgical removal can confirm echinococcal infection.